Mycoplasma Research Articles

Immune responses in children with secondary infection of mycoplasma pneumoniae after COVID-19: focus on eosinophils and IgE

BackgroundThe COVID-19 (SARS-CoV-2) epidemic has posed a major challenge to global public health, especially in children. Some children may experience secondary infection with Mycoplasma pneumoniae after SARS-CoV-2 infection, which has attracted widespread attention. Studies have shown that eosinophils play an important role in respiratory tract infections and are involved in regulating immune responses and inflammatory processes. However, there is a lack of systematic research on the specific manifestations and mechanisms of eosinophils in secondary infection with Mycoplasma pneumoniae after SARS-CoV-2 infection.ObjectiveThis study aims to explore the characteristics of immune response in children with SARS-CoV-2 infection and Mycoplasma pneumoniae infection, focusing on the changes in immune indicators such as eosinophils (EOS), immunoglobulin E (IgE), interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin (PCT).MethodsThis study is a retrospective observational study, and a total of pediatric patients who were treated in our hospital from January 2023 to December 2023 were included. The study group included children who were diagnosed with SARS-CoV-2 infection and further infected with Mycoplasma pneumoniae, and the control group included children who were only infected with SARS-CoV-2 and had no other pathogens. The clinical data of the two groups of patients, including absolute eosinophil value, IgE quantification, IL-6, CRP and PCT levels, were collected and analyzed, and statistical comparisons were performed.ResultsA total of 134 children were included, including 79 in the study group and 55 in the control group. The absolute eosinophil value [0.17 (0.09, 0.31) vs. 0.09 (0.06, 0.23), P < 0.01] and IgE level [59.28 (37.54, 256.88) vs. 22.00 (11.00, 113.10) P < 0.01] of the children in the study group were significantly higher than those in the control group, while IL-6 [16.81(4.72,31.86) vs. 9.5(3,57.3), P = 0.602], CRP [2.82(1.10,6.13) vs. 1.94(0.50,8.94), P = 0.528] and PCT[0.12(0.08,0.20) vs. 0.12(0.10,0.24), P = 0.329] were no significant difference between the two groups. Binary logistic regression analysis showed that the absolute value of eosinophils and IgE were independent risk factors for secondary infection of Mycoplasma pneumoniae after SARS-CoV-2 infection.ConclusionThis study shows that after SARS-CoV-2 infection, the increase in eosinophils and the increase in related immune indicators IgE may be closely related to secondary infection with Mycoplasma pneumoniae. This study provides an important basis for understanding the immune response of children after SARS-CoV-2 infection and its related clinical management, suggesting that clinicians should closely monitor the eosinophil count and IgE level of children after SARS-CoV-2 infection, especially for children at risk of secondary infection, so as to take timely intervention measures to prevent secondary infection with Mycoplasma pneumoniae and improve the prognosis of children.

Detection of Mycoplasma spp. from snakes from five different families

BackgroundMycoplasmas are an important cause of respiratory diseases in tortoises. In snakes, evidence of mycoplasma infections has been found almost exclusively in pythons. To better understand the occurrence of these bacteria in other snake species, samples submitted for routine testing for respiratory pathogens were also tested for mycoplasma by polymerase chain reaction (PCR). A total of 640 samples (mostly oral swabs) from snakes of 5 different families (Boidae n = 114, Colubridae n = 109, Elapidae n = 34, Pythonidae n = 301 and Viperidae n = 82) were included in the study. A genus-specific PCR (PCR1) developed for the detection of Mycoplasma [Mycoplasmopsis] agassizii and a pan-mycoplasma PCR (PCR2) were used. PCR products were sequenced for validation and phylogenetic analysis was performed. The sampled animals were from various owners and collections, all in human care at the time of sampling. Clinical background information was not provided.ResultsUsing PCR1, mycoplasmas were detected in 175 (175/640, 27%) samples (Boidae: 7/114, 6%; Colubridae: 3/109, 3%; Elapidae: 8/34, 24%; Pythonidae: 155/301, 51%; Viperidae: 2/82, 2%). A higher percentage of positive results were obtained using PCR2 (258/640, 40%; Boidae: 9/114, 8%; Colubridae: 25/109, 23%; Elapidae: 19/34, 56%; Pythonidae: 172/301, 57%; Viperidae: 33/82, 40%). The detected bacteria can be divided into at least 6 genetically diverse clusters representing different genera and species based on multiple sequence alignment and phylogenetic analysis.ConclusionsThese results show that diverse mycoplasmas are found in pythons and other snakes. Further investigations are necessary to evaluate the role of various mycoplasmas in respiratory diseases in snakes.

ОЦЕНКА ИММУННОГО СТАТУСА МОЛОДНЯКА СВИНЕЙ ПРИ МИКОПЛАЗМЕННОЙ ИНФЕКЦИИ

Pig farming still suffers significant economic losses due to infection of animals with mycoplasmas. The pathogenic effect of these bacteria on the body of pigs is especially pronounced in young animals. The purpose of research is to study the nature of the impact of mycoplasma infection on the immune status of piglets. To assess the epizootological state of the complex regarding mycoplasmosis, random blood tests were carried out from all technological groups of pigs using the RNG reaction and determining the percentage of infection. Morbidity was determined by the number of animals identified with clinical signs of the disease among those infected, and mortality was determined by the number of dead animals among those infected with mycoplasmosis. Blood protein fractions were determined in piglets using an ERBA-XL100 biochemical analyzer. Determination of T-lymphocytes was done by the method of spontaneous rosette formation with sheep erythrocytes (E-ROCK). Determination of B cells was carried out in the complementary rosette formation reaction (EAC-ROCK). It was established that the infection of pigs with mycoplasmosis in different groups at the complex ranged from 24.2–65.7 %, while the highest percentage of morbidity (26.8 %) and mortality (18.6 %) of individuals was observed among piglets in growing. The negative impact of mycoplasma infection on the immune status of young pigs was manifested by a decrease in total protein (by 13.5 %) and gamma globulin fraction (by 17.8 %) in the blood serum of sick piglets compared to healthy ones. The impact of pathogenic mycoplasmas on the cellular link of the immune-competent system of the body of sick piglets was manifested by a decrease in their T-lymphocytes by 11 %, and B-lymphocytes by 21.4 % compared to healthy animals.

The impact of Mycoplasma pneumoniae infection on platelets in children with immune thrombocytopenia: a real-world study from China.

Mycoplasma pneumoniae (M. pneumoniae), as one of the susceptible pathogens during childhood, may lead to severe mycoplasmal pneumonia and affect platelet fluctuations. We prospectively collected data on persistent/chronic ITP children who were infected with M. pneumoniae infection from August 2023 to December 2023. There were 64 patients (40 males) with a median age of 7.08 years (range 4.30 to 9.76) enrolled in this study. Overall, 33 (51.6%) children received TPO-RAs therapy and 31 (48.4%) received other treatments. The impact of M. pneumoniae infection on platelet count is bidirectional, but thrombocytopenia remains predominant. During M. pneumoniae infection, platelet changes in the TPO-RA group were higher than in the non-TPO-RA group. Thrombocytosis was observed in 6 patients (5 in the TPO-RA group vs. 1 in the non-TPO-RA group). Rescue treatment was implemented in 18 patients (7 in the TPO-RA group vs. 11 in the non-TPO-RA group). Monitoring platelets should be strengthened during M. pneumoniae infection.

Mycoplasma pneumoniae detections in children with acute respiratory infection, 2010–2023: a large sample study in China

BackgroundThis study aimed to describe the epidemiological trends of Mycoplasma pneumoniae (MP) infection among children with acute respiratory tract infections (ARTIs) before, during and after the COVID-19 pandemic, and evaluating the impact of non-pharmaceutical interventions (NPIs) on the epidemiology of MP infection.MethodsChildren with ARTIs admitted to the Children’s Hospital of Soochow University (SCH) from January 2010 to December 2023 and underwent MP nucleic acid PCR assay were included. Clinical data on age, sex, onset time and detection result were collected and analyzed.ResultsAll of the 122,984 inpatients were enrolled, in which 20.8% (25659/122984) of the children with MP tested positive, including 19.4% (14139/72662) for male and 22.9% (11520/50322) for female. It was a statistically significant difference between the two genders (p < 0.05). In addition, the positive rate of MP was the highest in the age group > 6 years old each year (p < 0.05). During 14-year period, the detection rate of MP has experienced four peaks in 2012, 2013, 2019, and 2023. Before the NPIs the prevalence of MP showed seasonality, and the number and rate of MP positivity reached their peak in August. However, the rate of MP positivity remained at a low level during the NPIs. After the abolition of NPIs, the MP positivity rate obviously increased and remained at a high level.ConclusionsThe NPIs could reduce the spread of MP infection and change its epidemic season, but it has not changed the susceptible population of MP infection.

Clinical profile and risk factors for respiratory failure in children with Mycoplasma pneumoniae infection.

Mycoplasma pneumoniae (MP) is a common cause of community-acquired pneumonia (CAP) in children and can lead to severe complications, including respiratory failure. A retrospective analysis of 2084 children diagnosed with CAP and treated in our hospital from January 2022 to January 2023 was conducted. A comprehensive dataset of patient demographics, clinical symptoms, and laboratory findings was initially assembled. Subsequent statistical analyses were carried out to elucidate the clinical characteristics of MP pneumonia (MPP) in children. Additionally, the study identified high-risk factors for respiratory failure in the context of MPP. Among the hospitalized MPP cases, 15.8% progressed to respiratory failure. Statistical analysis identified D-dimer level as a significant risk factor for respiratory failure in children with MPP. A predictive model was developed using D-dimer levels, yielding an area under the curve (AUC) of 0.818 with a cutoff value of 1.015 mg/L. The model demonstrated a sensitivity of 62.4% and a specificity of 91.3%, proving effective in predicting respiratory failure caused by MPP. Respiratory failure remains a critical complication in children with MPP, and D-dimer levels serve as a key predictive risk factor. Vigilant monitoring of coagulation function, particularly D-dimer levels, is essential for the early identification of patients at risk of developing respiratory failure in MPP cases.

Comparison of thromboelastographic profiles and clinical characteristics in children with severe Mycoplasma pneumoniae pneumonia

BackgroundThis study aimed to compare Thromboelastographic (TEG) profiles and clinical characteristics between severe Mycoplasma pneumoniae (MP) pneumonia patients with normal and abnormal TEG parameters.MethodsThe clinical data of 133 children with severe MP pneumonia were retrospectively analyzed. Patients were divided into normal (n = 76) and abnormal (n = 57) TEG groups. Demographic characteristics, clinical manifestations, laboratory findings, imaging features, bronchoscopy results, treatment, complications, and outcomes were compared between groups.ResultsThe abnormal TEG group (42.9%) had longer fever duration (median: 8.5 vs. 7.0 days, P &amp;lt; 0.001) and hospital stay (median: 11.5 vs. 10.0 days, P = 0.003). They also showed higher levels of C-reactive protein (median: 30.2 vs. 20.1 mg/L, P &amp;lt; 0.001), lactate dehydrogenase (median: 334.5 vs. 276.0 U/L, P = 0.001), and D-dimer (median: 1.2 vs. 0.5 μg/ml, P &amp;lt; 0.001). HRCT revealed more lobar consolidation or multilobar involvement (36.8% vs. 18.4%, P = 0.016), and bronchoscopy showed more mucous plug obstruction (28.1% vs. 10.5%, P = 0.008) in the abnormal TEG group. TEG parameters indicated a hypercoagulable state with shorter R time (P &amp;lt; 0.001), shorter K time (P &amp;lt; 0.001), and higher MA (P = 0.003). The abnormal TEG group had higher incidences of coagulopathy (P &amp;lt; 0.001), cardiac involvement (elevated cardiac enzymes: 36.8% vs. 17.1%, P = 0.009; pericardial effusion: 10.5% vs. 1.3%, P = 0.017), and plastic bronchitis (P = 0.006). They also required longer azithromycin courses (median: 15 vs. 14 days, P = 0.026).ConclusionChildren with severe MP pneumonia and abnormal TEG profiles have more severe clinical manifestations, higher inflammatory markers, more extensive lung involvement, and a higher incidence of complications. TEG may help identify high-risk patients and guide management in severe MP pneumonia.

The role of IFN-γ/CXCL10 axis in Mycoplasma pneumonia infection

Mycoplasma pneumoniae caused lower respiratory tract infection in children and can exacerbate these infections through the production of various inflammatory factors, with chemokines playing a key role. However, the pathogenesis of this infection is complicated and thus has not been thoroughly studied. We clarified that cytokine expression levels were analyzed in both peripheral blood and bronchoalveolar lavage fluid (BALF), and in vitro assays were conducted using THP-1 macrophages. We discovered that, compared to control children, M. pneumoniae pneumonia (MPP) patients expressed significantly higher levels of CXCL10 both in the peripheral blood and BALF. Moreover, numbers of macrophages, predominantly with a M1 phenotype, were significantly increased in BALFs of children of MPP. In vitro, coculture with IFN-γ or activated CD4+ Th1 cells significantly promoted CXCL10 expressions in THP-1 derived macrophages, which was largely reversed by siRNA-mediated down regulation of STAT1. In addition, IFN-γ-stimulated macrophages greatly promoted the trans-migration of Th1 cells. our data show that Th1 cells-derived IFN-γ augments CXCL10 production in macrophages via the JAK-STAT1 pathway, which subsequently recruits more immune cells like Th1 cells into the infection sites, thereby constituting a positive feedback loop and aggravating the type I inflammatory responses in MPP patients.

Cocaine-Induced Limbic Encephalopathy Manifesting as Acute Amnesia: A Case Report

Background: Cocaine has been shown to cause cytotoxic neuronal damage, which has been implicated in cases of leukoencephalopathy. We present a case of cocaine-induced toxic encephalopathy resulting in predominant lesions to the gray matter on magnetic resonance imaging (MRI). Case Presentation: A 70-year-old female presented acutely with confusion, agitation, and disorientation. She was markedly hypertensive with other vital signs within normal range. On presentation to the emergency department, she was uncooperative and had an unsteady gait but showed no focal neurological deficits. Her lab work was positive for elevated cardiac troponins, elevated D-dimer, and a urine drug screen positive only for cocaine. Head computed tomography (CT) showed no hemorrhage and head CT angiogram showed no abnormalities and no significant vascular stenosis. Chest X-ray and CT showed diffuse ground glass opacities compatible with atypical pneumonia. Antibiotics were initiated to treat the pneumonia and antihypertensives were administered to manage her blood pressure. She was also given IV thiamine. Brain MRI showed restricted diffusion involving bilateral hippocampi, thalami, putamen, caudate, and right occipital lobe, findings suspicious for cytotoxic edema. After acute stabilization, the patient demonstrated profound anterograde and retrograde amnesia, which improved gradually over days to weeks. She was eventually discharged to a skilled nursing facility. Conclusion: To our knowledge, this is the first reported case of profound amnesia secondary to cocaine-induced toxic encephalopathy with bilateral hippocampal involvement. These symptoms correlate with the implicated neuroanatomical structures. This case demonstrates that cocaine may be implicated in toxic encephalopathy affecting the brain’s gray matter and highlights a unique presentation of these findings.

The impact of atopy on the clinical characteristics of mycoplasma pneumoniae pneumonia in pediatric patients

Mycoplasma pneumoniae (MP) is one of the pathogens that cause community-acquired pneumonia in children. Atopic diseases are also common in children. However, the impact of atopy on Mycoplasma pneumoniae pneumonia (MPP) in children is still unclear. The purpose of this study is to analyze the impact of atopy on the clinical characteristics of MPP in children, and provide a diagnosis and treatment plan. A total of 489 children hospitalized for MPP in our hospital from June 2023 to December 2023 were selected. They were divided into an atopic group (n = 172) and a non-atopic group (n = 317) based on whether they had atopy or not. Clinical data, treatment regimens, and laboratory indicators were compared between the two groups. Eosinophil count, lactate dehydrogenase and IgE levels were higher in the atopic group than in the non-atopic group. Additionally, neutrophil percentage, procalcitonin levels were lower in the atopic group than in the non-atopic group (P < 0.05). The proportion of bronchiolitis type on lung imaging was higher in the atopic group, and there was a higher incidence of severe pneumonia compared to the non-atopic group (P < 0.05). Atopy may lead to severe MPP and bronchiolitis-type MPP. Therefore, the treatment and prognosis of these children should be given more attention.

Exploring Pneumonia: Understanding its Epidemiology, Deciphering Pathogenic Complexities, and Developing Advanced Diagnostic and Therapeutic Approaches

Pneumonia, a widespread respiratory infection affecting the alveoli and lung parenchyma, continues to be a major global health concern, particularly in children. Despite advancements in vaccine development and anti-infective therapies, pneumonia is a leading cause of death, particularly among children and the elderly. It accounts for approximately 14% of all deaths in children under five years of age globally, with over 700,000 deaths occurring annually. In adults, especially those over 65 years of age, pneumonia significantly increases mortality, contributing to over 1 million deaths yearly worldwide. Community-acquired Pneumonia (CAP) is predominantly caused by Streptococcus pneumoniae, Mycoplasma pneumoniae, and Chlamydia pneumoniae. Streptococcus pneumoniae is the leading pathogen, particularly in infants, the elderly, and immunocompromised individuals, often resulting in severe clinical presentations. Mycoplasma pneumoniae causes milder, atypical pneumonia, commonly referred to as “walking pneumonia”, affecting young adults and adolescents. Chlamydia pneumoniae is also a significant cause of mild to moderate respiratory infections, particularly in school-aged children. The identification of these pathogens is critical for guiding empirical antimicrobial therapy, as the clinical severity and response to treatment vary with each microorganism. This review aimed to explore the intricacies of pneumonia pathogenesis and provide insights into the role of various microorganisms in its development. By emphasizing the importance of timely and appropriate antimicrobial therapy, the review further aims to underscore the need for rapid, accurate diagnostic tests capable of detecting pathogens and antibiotic resistance. Therefore, improving diagnostic capabilities and targeted treatments is essential for effective pneumonia management. The complexity of pneumonia pathogenesis and the variety of causative microorganisms require rapid, accurate diagnostic tests to guide appropriate therapy.

Protective immunity induced by a novel P1 adhesin C-terminal anchored mRNA vaccine against Mycoplasma pneumoniae infection in BALB/c mice.

Mycoplasma pneumoniae (Mp), a unique pathogen devoid of a cell wall, is naturally impervious to penicillin antibiotics. This bacterium is the causative agent of M. pneumoniae pneumonia, an acute pulmonary affliction marked by interstitial lung damage. Non-macrolide medications may have potential adverse effects on the developmental trajectory of children, thereby establishing macrolides as the preferred treatment for M. pneumoniae in pediatric patients. However, the emergence of macrolide-resistant and multidrug-resistant strains of M. pneumoniae presents significant challenges to clinical management and public health. Vaccines, particularly those based on mRNA technology, are regarded as a promising avenue for preventing and controlling M. pneumoniae infections due to their inherent safety, immunogenicity, and adaptability. Our research delves into the P1 adhesin of M. pneumoniae, a protein that binds to host cell receptors with its immunodominant epitopes located at the carboxyl terminus, known to provoke robust immune responses and pulmonary inflammation. We have developed an mRNA vaccine harnessing this dominant antigenic epitope and assessed its protective immunity in BALB/c mice against M. pneumoniae infection. The vaccine elicited potent humoral and cellular immune responses, effectively diminishing inflammation. It notably decreased IL-6 levels in the lungs of infected mice and concurrently elevated IL-4, IL-10, and IFN-γ levels post-immunization. The vaccine also reduced pathological changes in the lungs and the M. pneumoniae DNA copy numbers in the infected animals. Collectively, these findings underscore the mRNA vaccine's remarkable immunogenicity and protective potential against M. pneumoniae infections, offering valuable insights for the development of mRNA vaccines targeting mycoplasma infections.IMPORTANCEM. pneumoniae, a bacteria without a cell wall, is known for causing pneumonia and is resistant to penicillin. The increasing prevalence of macrolide-resistant strains has complicated treatment options, emphasizing the need for new strategies. Our research explores an mRNA vaccine candidate that targets the P1 adhesin of M. pneumoniae, a protein critical for the bacteria's interaction with host cells. In a mouse model, this vaccine has shown potential by inducing immune responses and suggesting a possible reduction in inflammation, as indicated by changes in cytokine levels and lung pathology. While further research is required, the vaccine's preliminary results hint at a potential new direction in managing mycoplasma infections, offering a promising avenue for future therapeutic development. This study contributes to the ongoing search for effective preventive measures against M. pneumoniae.

Prevalence and Antimicrobial Susceptibility of Mycoplasma hominis and Ureaplasma Species among Women in Dakar

Introduction: Genital mycoplasmas, which cause infections of the lower reproductive tract in women, are a major cause of morbidity and complications. The aim of this study was to determine the prevalence of mycoplasma infections and the antibiotic susceptibility profile among women in Dakar. Material and methods: We conducted a retrospective descriptive study over a four-year period, from 02 January 2018 to 31 December 2021. The study population consisted of women referred to the microbiology laboratory at Military Hospital of Ouakam for genital mycoplasma testing. The Mycoplasma IES kit was used for mycoplasma testing and susceptibility testing in accordance with the manufacturer's recommendations. Results: A total of 1431 patients were enrolled during the study period. The mean age was 32.6 ± 8.5 years. The overall prevalence of mycoplasma infection was 55.8% (798/1431). Of the 798 positive cultures, 52.8% were infected with Ureaplasma urealyticum (UU) and 17.9% with Mycoplasma hominis (MH). UU+MH co-infection was 31.08%. Analysis of the sensitivity profiles showed that UU was sensitive to most of the antibiotics used, while M. hominis strains showed low levels of resistance to tetracyclines (TET DOX, MIN), quinolones (OFX, LEV, SPA) and JOS. This resistance was much higher with macrolides (ERY, ROX, AZT), certain quinolones (ASP, CIP) and aminoglycosides (SPE). However, M. hominis strains were much more resistant to these molecules than U. urealitycum isolates. Conclusion: Our study revealed a high rate of genital mycoplasma infection among women in Dakar. The high rates of resistance to certain molecules underline the importance of surveillance to prevent transmission of resistant strains and rational use of antibiotics.

A diagnostic host-specific transcriptome response for Mycoplasma pneumoniae pneumonia to guide pediatric patient treatment

Mycoplasma pneumoniae causes atypical pneumonia in children and young adults. Its lack of a cell wall makes it resistant to beta-lactams, which are the first-line treatment for typical pneumonia. Current diagnostic tests are time-consuming and have low specificity, leading clinicians to administer empirical antibiotics. Using a LASSO regression simulation approach and blood microarray data from 107 children with pneumonia (including 30 M. pneumoniae) we identify eight different transcriptomic signatures, ranging from 3-10 transcripts, that differentiate mycoplasma pneumonia from other bacterial/viral pneumonias with high accuracy (AUC: 0.84–0.95). Additionally, we demonstrate that existing signatures for broadly distinguishing viral/bacterial infections and viral/bacterial pneumonias are ineffective in distinguishing M. pneumoniae from viral pneumonia. The new signatures are successfully validated in an independent RNAseq cohort of children with pneumonia, demonstrating their robustness. The high sensibility of these signatures presents a valuable opportunity to guide the treatment and management of M. pneumoniae pneumonia patients.

Improvement of IL-4, IL-6, IL-10, TNF-α and IFN-γ in children with mycoplasma pneumonia through the combination of video scenario-based breathing training and antibiotics.

This study aims to investigate the effects of video scenario-based breathing training on interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) in children with Mycoplasma pneumonia. A total of 106 children with Mycoplasma pneumonia treated in our hospital from February 2022 to April 2024 were selected. According to different nursing methods, children receiving routine intervention were assigned to the control group, while those undergoing video scenario-based breathing training were assigned to the training group. The serum inflammatory indexes, improvement time of clinical symptoms and lung function recovery were compared between the two groups before training, and at 1 and 2 weeks after training. Before training, there was no statistically significant difference in serum inflammatory and lung function indexes between the two groups (p > 0.05). After 1 and 2 weeks of training, the forced expiratory volume in 1s (FEV1), peak expiratory flow rate (PEF), and the ratio of FEV1 to forced vital capacity (FEV1/FVC) in both groups increased, with higher values in the training group than in the control group, and the difference was statistically significant (p < 0.05). The time for cough disappearance, wheezing disappearance, lung rales disappearance and high fever abatement in the training group was lower than that in the control group, with statistically significant differences (p < 0.05). The levels of IL-4, IL-6, IL-10, TNF-α, and IFN-γ decreased in both groups, with lower levels in the training group than in the control group, and the difference was statistically significant (p < 0.05). Video scenario-based breathing training can improve lung function, alleviate clinical symptoms and signs, and reduce serum inflammatory levels of IL-4, IL-6, IL-10, TNF-α and IFN-γ in children with Mycoplasma pneumonia.

Calling for attention to prevention and treatment of Mycoplasma pneumoniae infection in children during the fall-winter seasons

Mycoplasma pneumoniae (MP) is a common cause of community-acquired pneumonia in children in China, and it is often prevalent in the autumn and winter seasons. In the autumn and winter of 2023, a large-scale epidemic outbreak of MP pneumonia occurred nationwide in the pediatric population, which brought harm to child health, caused a heavy disease burden, imposed a challenge to the pediatric medical service system, and aroused great attention from medical administration and public health fields. The widespread prevalence of macrolide-resistant MP (MRMP) in China has become a prominent problem in pediatric clinical practice. This article reviewed the epidemiology of MP pneumonia and made evidence-based suggestions for the prevention and treatment of seasonal MP pneumonia in children in terms of the current clinical practice issues and public health concerns.

Atypical Pneumonia in the Elderly: A Meta-Analysis of Risk Factors, Treatment Outcomes, and Mortality

Background: Atypical pneumonia poses a significant threat to elderly individuals, often leading to severe complications and increased mortality. This meta-analysis aimed to evaluate risk factors, treatment outcomes, and mortality associated with atypical pneumonia in elderly patients. Methods: A systematic search of PubMed, Embase, and Cochrane Library databases was conducted from January 2013 to December 2024. Studies reporting on atypical pneumonia in patients aged 65 years or older were included. Data on risk factors, treatment outcomes (clinical cure rate, radiological improvement, length of hospital stay), and mortality were extracted and pooled using random-effects models. Results: Six studies involving 1,875 elderly patients with atypical pneumonia were included. Advanced age (≥80 years), comorbidities (chronic obstructive pulmonary disease, heart failure, diabetes mellitus), and delayed initiation of antibiotic therapy were identified as significant risk factors for severe disease and mortality. Treatment with macrolides was associated with a higher clinical cure rate (OR 2.15, 95% CI 1.52-3.04, p&lt;0.001) and shorter hospital stay (mean difference -2.8 days, 95% CI -4.1 to -1.5, p&lt;0.001) compared to fluoroquinolones. The pooled mortality rate was 12.8% (95% CI 9.5-16.1%). Conclusion: Atypical pneumonia in the elderly is associated with significant morbidity and mortality. Early recognition of risk factors and prompt initiation of appropriate antibiotic therapy, particularly with macrolides, are crucial for improving outcomes in this vulnerable population.

The Clinical Value of Novel Inflammatory Biomarkers for Predicting Mycoplasma pneumoniae Infection in Children.

Mycoplasma pneumoniae (MP) is a major cause of community-acquired pneumonia (CAP), posing diagnostic challenges. This study evaluates novel inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and system inflammation response index (SIRI) for MP diagnosis in children. Complete blood count (CBC) results of 424 children with MP infection and 150 health children were collected. NLR, MLR, PLR, SII and SIRI, were respectively calculated. Shapiro-Wilk test, Student's t-test, Mann-Whitney U-test and Pearson chi-squared test were used to analyze the clinical data of the patients and participants. Multiple logistic regression analysis was conducted based on the results of single factor analysis. Receiver operating characteristic (ROC) curve was drawn to evaluate the potential of the above biomarkers for MP infection. Compared with the control group, white blood cell (WBC) count, neutrophil (NEU) count, monocyte (MON) count, NLR, MLR, PLR, SII and SIRI were significantly higher and lymphocyte count (LYM) and platelet (PLT) were significantly lower than those in MP group. The results of multivariate logistic regression analysis indicate that MLR and SIRI can serve as major risk factors for MP infection in children. The predictive accuracy of logistic regression model based on MLR and SIRI is 83.28%. The area under the curve (AUC) results showed that SIRI has better predicting value of MP infection (AUC = 0.892, Sensitivity = 75.7%, Specificity = 92.0%). This study described the significance of novel inflammatory biomarkers in children with MP infection and may provide new auxiliary diagnostic indicators for MP infection.

Analysis of antibody detection data of Mycoplasma pneumoniae in a hospital in Beijing City from 2017 to 2024

Objective: To explore the distribution characteristics of Mycoplasma pneumoniae (MP) antibody detection data in hospital, provide data reference for the prevention and control of MP infections. Methods: A single-center retrospective study was conducted on 20 639 patients with suspected Mycoplasma pneumoniae (MP) infection from March 2017 to February 2024 at the outpatient, emergency, and inpatient departments of Peking University Third Hospital. The age range was from 0 to 105 years, with 11 286 males and 9 353 females. The passive agglutination method was used to detect MP antibodies in patient serum, and SPSS 22.0 statistical software was used for statistical analysis. The χ2 test was used to analyze the differences in positive rates of MP antibodies among different genders, age groups, seasons, years, and antibody titers. The trend χ2 test was used to analyze the trend of detection rates with age changes. Results: Among the 20 639 patients, the positive rate of MP antibodies was 23.19%(4 786/20 639), with a higher positive rate in females was 27.16%(2 540/9 353) compared to males (19.90%, 2 246/11 286;χ²=151.191, P<0.01). The positive rate in children was 37.13%(2 731/7 356)significantly higher than in adults(15.47%, 2 055/13 283;χ²=1 246.433, P<0.01). The 6 to <12 year age group (63.11%, 1 223/1 938) had the highest positive rate of MP antibodies, followed by 12 to <18 year old group (56.78%, 385/678). The positive rate of MP antibodies increased with age from 0 to 12 years old but gradually decreased after 12 to <18 years old (χ2=3 848.393, P trend<0.01). The annual MP antibody positivity rates from 2017 to 2023 were 26.92%, 29.23%, 27.46%, 18.43%, 17.16%, 11.89%, and 23.72%, respectively, with statistically significant differences among the years (χ²=387.519, P<0.01). The MP antibody positive rate was high in autumn over the course of 7 years (χ²=242.560, P<0.01). The positive rates of MP antibodies for the years 2017-2019, 2020-2022, and 2023-2024 are (28.00%, 16.60%, 21.84%), respectively, with statistically significant differences among the three periods(χ²=295.845, P<0.01).The monthly positive rates of MP antibody in different years were (5.63% to 43.11%). In the MP antibody titer, qualitative testing was conducted on 4 563 patients and 16 076 patients had a semi-quantitative MP antibody titer of ≥1∶160 with a positive rate of 16.03%(2 577/16 076). Among the proportion of children with high titers of MP antibodies ≥1∶1 280 was 11.11%(798/7 182). Conclusion: The positive rates of MP antibodies in hospital in the Beijing area vary among different genders, ages, and seasons, with a higher incidence in autumn, mainly among children and adolescents.

Atypical presentation of tuberculosis in a 38-year-old daily wage worker: A case report

We present a case of pulmonary tuberculosis (PTB) in a 38-year-old male smoker and alcoholic with an atypical and varied presentation. The patient was a daily wage worker who exhibited symptoms of dry cough and dyspnea but lacked the classic features of fever, weight loss, chest pain, and hemoptysis. Chest X-ray revealed non-homogeneous opacities and multiple small cavities in both lungs, initially raising suspicion for community-acquired pneumonia, atypical pneumonia, or polyangiitis. Acid-fast bacilli (AFB) testing and then line probe assay (LPA) ultimately confirmed the diagnosis of Mycobacterium tuberculosis (Mtb), which is sensitive to isoniazid and rifampicin. This case highlights the variable nature of presentation in tuberculosis (TB), the importance of maintaining a broad differential diagnosis even in the absence of typical symptoms, and the importance of microbiological diagnosis for accurate diagnosis. Risk factors of tuberculosis like smoking and alcoholism, should be considered along with the screening of common comorbidities like diabetes.